We invite medical workers at Providence and across the country to write to us about the conditions they face as a result of the ongoing social crisis, the COVID-19 pandemic and the emerging threats to public health by the Trump administration.

Striking healthcare workers from eight Providence hospitals in Oregon have overwhelmingly rejected the latest contract offer, marking a significant setback in negotiations. The Oregon Nurses Association (ONA) reported that 92 percent of their members participated in the vote, with 83 percent of those voting against ratifying the agreement. The vote extends a strike that began on January 10, 2025, involving approximately 5,000 healthcare workers.

The tentative agreement, reached after 26 days of striking, was an insult to the rank and file. It failed to meet their core demands, particularly concerning wages, safe staffing ratios, health care benefits for workers and their families, and adequate compensation for missed breaks and lunches. The rejection underscores a deep dissatisfaction not only with the proposed terms, but with the bargaining committee, which brought the contract to a vote.

The vote makes clear the need for nurses to establish rank-and-file committees to establish democratic control of the strike. To carry their fight forward, they must break through the straitjacket of the union apparatus and the entire political establishment. They must turn outward to their class brothers and sisters in the broader working class to forge a unified fight for public health and to defend democratic rights.

Working conditions have been nothing short of deplorable. Chronic understaffing has led to untenable workloads, forcing nurses to care for an overwhelming number of patients without adequate support. This situation not only endangers patient safety but also contributes to severe burnout among healthcare workers.

The physical and emotional toll of such conditions is exacerbated by the lack of sufficient breaks and the constant pressure to perform under constant strain. The proposed agreement’s failure to guarantee safe staffing ratios and appropriate compensation for missed breaks was seen as a blatant disregard for the nurses’ wellbeing and the quality of patient care.

The tentative agreement proposed to its members was a strategic move by the union leadership to wear the strike down. The ONA declared that its “bargaining teams approached negotiations and this strike, in good faith—even when Providence has not. To demonstrate our good faith, after Providence claimed this was the best offer they could make, bargaining teams sent this contract to be voted on by ONA members so they could provide clear feedback to Providence on the proposed settlement.”

By pushing forward an insulting proposal which met none of the workers’ actual demands, the union bureaucracy sought to undermine the growing militancy of the rank and file and sow discouragement. But there is enormous potential to expand the strike and link up with healthcare workers across the country, as shown by strikes last week in New Orleans and Pennsylvania hospitals.

But the ONA bureaucracy is trying to divide workers by reaching a separate tentative agreement for the six Providence Women’s Clinic locations across the state. The agreement was reached in secret and its purpose was to isolate the remaining strikers and pressuring them into accepting a similar sellout deal. But the striking hospital nurses threw a wrench into this plan.

The rejection of this agreement is part of a broader pattern of workers coming into conflict against the union bureaucracy. In the last year alone, workers have rejected numerous tentative agreements that failed to address critical issues, from USPS carriers to BNSF workers to Boeing workers to railroad conductors and maintenance of way workers. These rejections highlight a growing chasm between rank-and-file workers and union bureaucracies, which are aligned with management interests rather than those of their members.

The current political climate under the Trump administration exacerbates the challenges faced by workers. Recent executive orders have dismantled constitutional and democratic rights, attacked immigrant workers, and imposed restrictions on healthcare funding. These actions not only undermine worker protections but will also create a more hostile and precarious working environment.

Moreover, the administration’s aggressive moves to dismantle agencies and lay off tens of thousands of federal workers have led to significant job losses and a reduction in essential services. The abrupt defunding and dismantling of health programs have jeopardized global health initiatives and left thousands of workers unemployed, highlighting the administration’s disregard for both domestic and international labor.

In the healthcare field, the appointment of Robert F. Kennedy Jr. as Secretary of Health and Human Services (HHS) shows the Trump government is planning nothing less than full-scale warfare against public health. His appointment, along with others in key health roles, signals a dangerous shift away from science-based approaches, putting both public health and healthcare workers at significant risk.

These actions set a dangerous precedent, signaling a broader assault on worker rights and protections. The healthcare industry, already strained by the pandemic and chronic underfunding, is particularly vulnerable to these attacks. The rejection of the tentative agreement by Providence nurses is thus not only a stand against inadequate working conditions but also a broader act of resistance against a political agenda that seeks to erode worker rights and dismantle public services.

In this context, the formation of rank-and-file committees becomes even more critical. These committees can serve as a bulwark against bosses, union betrayals and political attacks from the state, empowering workers to take collective action to win their demands.

The significance of workers’ independent rank-and-file committees cannot be overstated. They represent a necessary measure towards direct worker control and decision-making, free from the constraints of traditional union hierarchies and political affiliations, particularly the Democratic Party, which has historically co-opted labor movements to serve its interests. By forming these committees, workers can more effectively organize, communicate, educate and fight for their interests, ensuring that their voices are heard, and their demands are met without dilution or compromise.

The Providence nurses’ rejection of the tentative agreement is a call for workers everywhere. It underscores the urgency of independent organization, the importance of uniting across different industries, and the imperative of standing firm against fascism and any political agenda that threatens workers’ lives.

The Providence nurses have taken a correct initial step in rejecting a sellout deal. It is now necessary to expand the struggle and it is incumbent upon workers across all sectors to support them, organize independently, and fight relentlessly for a socialist strategy that places human need at the top of the priorities.